Objective To investigate the efficacy and security of cypher stent(sirolimus-eluting stent)in the treatment of old patients with coronary heart disease(CHD).Methods From November 2002 to May 2005,328 elderly CHD cases(age:60-86 years)were treated with 415 Cypher stents.Among the 328 patients,66 had ST-segment elevation of myocardial infarction,21 had non ST-segment elevation of myocardial infarction,149 had unstable angina and 92 had stable angina.As for lesion characteristics,diffuse disease was found in 91 case(26.1%),bifurcation lesions in 68 cases(19.6%),chronic total occlusion lesions in 56 cases(16.0%),in-stent restenosis in 14 cases and ostial lesions in 15 case.The immediate angiographic outcome,major cardiac event(MACE) and angiographic follow-up at 6 months were assessed.Results Stent implantation was successfully achieved in 99% patients with CHD.Acute and sub-acute stent thrombosis occurred in 2 patients,late stent thrombosis with AMI occurred in 2 patients,1 died during the 6 months follow-up.The MACE rate during hospitalization was 0.6% and 3.6% during 6 months follow-up.Angiographic follow-up in 84 patients at 6 months showed that in-stent restenosis rate(ISR)was 8.3%(restenosis within the stents was 2.4%).The target vessel revascularization(TLR)rate was 5.9%.Conclusions Cypher stent implantation in CHD is safe and effective,the ISR rate and TLR rate are significantly lower than those of bare metal stents.

OBJECTIVETo observe the influence of Xinmaitong capsule (XMT) on serum matrix metalloproteinases-9, high sensitive C-reactive protein levels in patients with acute coronary syndrome.

METHOD63 cases were divided by randomized, contrastive assigned to XMT group (n = 31) and control group (n = 32). The serum levels of MMP-9 and hs-CRP before and after treatment in 12 weeks were detected.

RESULTAfter treatment, the serum levels of MMP-9 in control group had no changed and the levels of hs-CRP reduced. The serum levels of MMP-9 and hs-CRP in XMT group had significantly decreased. The serum levels of MMP-9 and hs-CRP had positive correlation, but had no correlation to levels of serum lipids.

CONCLUSIONXMT decreased breakdown of matrix collagen, and inflammatory reaction in the patients of ACS, which may have effect on plaque stabilization.

Acute Coronary Syndrome ; blood ; drug therapy ; Aged ; C-Reactive Protein ; metabolism ; Capsules ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; therapeutic use ; Female ; Humans ; Male ; Matrix Metalloproteinase 9 ; blood ; Middle Aged ; Phytotherapy ; Plants, Medicinal ; chemistry ; Triglycerides ; blood

Objective To evaluate the pharmacokinetics parameters of cefazolin sodium pentahydrate and cefazolin sodium in beagle dogs after intravenous injection.Methods Six healthy beagle dogs were involved in the single -dose, double -cycle, randomized, and cross -over study.Six dogs were randomly divided into two groups , and each was given a single dose of 55 mg · kg -1 cefazolin sodium pentahydrate or ce-fazolin sodium in order to study pharmacokinetics of cefazolin sodium in plasma.The washout period lasted for 7 days.Concentrations were deter-mined by HPLC method.The pharmacokinetics parameters were evalua-ted by DAS 2.0 software.Results The main pharmacokinetic parameters of cefazolin sodium test and reference preparations were as follows:t1/2 were (1.34 ±0.15), (1.31 ±0.17 ) h; Cmax were(181.14 ±28.13 ), ( 171.18 ± 24.70 ) μg · mL-1; tmax were ( 0.75 ± 0.10 ) , (0.71 ±0.10) h;AUC0-t were(342.57 ±76.02), (323.33 ±40.59)μg · h · mL-1.Conclusion After single intravenous administration , there are differences between pharmacokinetic parameters of the test and the reference drugs in beagle dogs , such as AUC0-t, AUC0-∞ and Cmax.

Objective To investigate the difference of stability be-tween cefazolin sodium pentahydrate and amorphous cefazolin sodium. Methods Cefazolin sodium pentahydrate and amorphous cefazolin sodium from two manufacturers were processed rubber plug inverted test and vibration test, and then dissolved in the sterile water for injec-tion and 0.9% sodium chloride injection.The dissolving process was observed by an optical microscopy.Results In rubber plug inverted test and vibration test, cefazolin sodium pentahydrate almost was dis-solved while amorphous cefazolin sodium had different degrees of un-dissolved drugs by microscope observation.Conclusion The stability of cefazolin sodium pentahydrate is superior to that of amorphous ce-fazolin sodium.

Objective To explore the protective effect of nicorandil combined with rosuvastatin on myocardial tissue in patients who underwent percutaneous coronary intervention (PCI).Methods A total of 68 patients with coronary heart diseases (CHD) who underwent PCI were randomly divided into control group (36 cases) and treatment group (32 cases).The control group was treated with rosuvastatin 10 mg once daily for 3 d before PCI.The treatment group was given nicorandil 5 mg three times daily for 3 d before PCI on the basis of control group.Levels of serum high-sensitive troponin T (hs-cTnT),high-sensitive C-reactive protein (hs-CRP),tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10)were measured before PCI and 24,48 h after PCI.Results The markedly effective rates in treatment group and control group were 78.13％ (25/32),52.78％ (19/36),with significant difference (P ＜ 0.05).Before PCI,the levels of hs-cTnT in the treatment group and control group were (36.56 ± 15.35),(30.29 ± 13.67) pg · mL-1,hs-CRP were (3.67 ± 1.24),(3.53 ± 1.32) mg · L-1,TNF-α were (6.54 ± 2.42),(6.76 ±2.15)pg · mL-1,IL-10 were(6.87 ± 1.92),(7.02 ± 1.85)pg · mL-1.At 24 h after PCI,the levels of hs-cTnTwere(71.25 ± 17.87),(82.65 ± 18.34)pg · mL-1,hs-CRP were(9.48 ±2.35),(13.56 ±3.52) mg · L-1,TNF-α were(8.72 ± 2.26),(10.65 ± 3.16) pg· mL-1,IL-10 were (13.55 ± 4.51),(11.21 ± 3.54) pg · mL-1 At 48 h after PCI,the levels of hs-cTnT were(60.56 ± 15.64),(73.54 ± 16.51)pg · mL-1,hs-CRP were(6.62±1.98),(10.24±2.84)mg· L-1,TNF-α were(7.56±1.86),(8.86±1.95)pg· mL-1,IL-10 were(11.16 ± 3.28),(9.76 ± 3.11) pg · mL-1,and the differences of all the parameters above between the two groups were statistically significant (P ＜ 0.05).No adverse drug reactions were found in both groups.Conclusion Nicorandil combined with rosuvastatin before PCI is able to reduce inflammatory factors,improve the level of IL-10 and alleviate myocardial injury,with high safety profile.

Clinically common patients with severe diseases such as sepsis,burns,subarachnoid hemorrhage,and traumatic brain injury have increased renal solute clearance,it's called augmented renal clearance(ARC).When such patients are given drugs that are excreted mainly by the kidneys,the drug does not reach effective therapeutic concentration levels,thereby increasing the risk of treatment failure.In recent years,this phenomenon has attracted more and more attention,but because its mechanism is not clear,it also limits the development of animal models for ARC research to a certain extent.Therefore,it is of great significance to establish corresponding animal models based on ARC-related risk factors for in-depth study of the mechanism of ARC occurrence.This article reviews the related animal models from the diseases with high incidence of clinical ARC,aiming to provide reference for the development of ARC animal models.

OBJECTIVETo observe the effect of fluid shear stress on the eNOS gene expression and NO production in endothelial progenitor cells (EPCs).

METHODSThe peripheral blood mononuclear cells from healthy volunteers were inducted into EPCs and divided into stationary group (0 dyn/cm(2), 1 dyn/cm(2) = 0.1 Pa), low-flow shear stress group (5 dyn/cm(2)), medium-flow shear stress group (15 dyn/cm(2)) and high-flow shear stress group (25 dyn/cm(2)). The effects of shear stress on the endothelial nitric oxide synthase (eNOS) gene expression and nitric oxide (NO) production in human EPCs were measured.

RESULTSTypical "spindle-shaped" appearance was shown in EPCs derived from peripheral blood mononuclear cells and were positively labeled by acetylated-LDL, lectin, FLK-1 and vWF. After 4 hours treatment with various shear stresses, the ratio of eNOS/beta-actin mRNA expression by human EPCs in low, medium and high-flow shear stress group was 0.364, 0.505 and 0.548 respectively, which was significantly higher than that in stationary group (0.183, all P < 0.05) and the NO secretion in human EPCs in low, medium and high-flow shear stress group was also significantly higher than that in stationary group (all P < 0.05).

CONCLUSIONFluid shear stress enhances the eNOS mRNA expression and NO secretion in human EPCs, therefore, shear stress could potentiate the repair efficacy of EPCs for endothelial injury.

Cell Differentiation ; Cells, Cultured ; Endothelial Cells ; cytology ; metabolism ; secretion ; Humans ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type III ; genetics ; metabolism ; Stem Cells ; cytology ; metabolism ; secretion ; Stress, Mechanical

Background: Intrahepatic cholangiocarcinoma (ICC) is a highly desmoplastic tumor with poor prognosis even after curative resection. We investigated the associations between the composition of the ICC stroma and immune cell infiltration and aimed to develop a stromal-immune signature to predict prognosis in surgically treated ICC. Patients and methods: We recruited 359 ICC patients and performed immunohistochemistry to detect α-smooth muscle actin (α-SMA), CD3, CD4, CD8, Foxp3, CD68, and CD66b. Aniline was used to stain collagen deposition. Survival analyses were performed to detect prognostic values of these markers. Recursive partitioning for a discrete-time survival tree was applied to define a stromal-immune signature with distinct prognostic value. We delineated an integrated stromal-immune signature based on immune cell subpopulations and stromal composition to distinguish subgroups with different recurrence-free survival (RFS) and overall survival (OS) time. Results: We defined four major patterns of ICC stroma composition according to the distributions of α-SMA and collagen: dormant (α-SMAlow/collagenhigh), fibrogenic (α-SMAhigh/collagenhigh), inert (α-SMAlow/collagenlow), and fibrolytic (α-SMAhigh/collagenlow). The stroma types were characterized by distinct patterns of infiltration by immune cells. We divided patients into six classes. Class I, characterized by high CD8 expression and dormant stroma, displayed the longest RFS and OS, whereas Class VI, characterized by low CD8 expression and high CD66b expression, displayed the shortest RFS and OS. The integrated stromal-immune signature was consolidated in a validation cohort. Conclusion We developed and validated a stromal-immune signature to predict prognosis in surgically treated ICC. These findings provide new insights into the stromal-immune response to ICC.

Background: Intrahepatic cholangiocarcinoma (ICC) is a highly desmoplastic tumor with poor prognosis even after curative resection. We investigated the associations between the composition of the ICC stroma and immune cell infiltration and aimed to develop a stromal-immune signature to predict prognosis in surgically treated ICC. Patients and methods: We recruited 359 ICC patients and performed immunohistochemistry to detect α-smooth muscle actin (α-SMA), CD3, CD4, CD8, Foxp3, CD68, and CD66b. Aniline was used to stain collagen deposition. Survival analyses were performed to detect prognostic values of these markers. Recursive partitioning for a discrete-time survival tree was applied to define a stromal-immune signature with distinct prognostic value. We delineated an integrated stromal-immune signature based on immune cell subpopulations and stromal composition to distinguish subgroups with different recurrence-free survival (RFS) and overall survival (OS) time. Results: We defined four major patterns of ICC stroma composition according to the distributions of α-SMA and collagen: dormant (α-SMAlow/collagenhigh), fibrogenic (α-SMAhigh/collagenhigh), inert (α-SMAlow/collagenlow), and fibrolytic (α-SMAhigh/collagenlow). The stroma types were characterized by distinct patterns of infiltration by immune cells. We divided patients into six classes. Class I, characterized by high CD8 expression and dormant stroma, displayed the longest RFS and OS, whereas Class VI, characterized by low CD8 expression and high CD66b expression, displayed the shortest RFS and OS. The integrated stromal-immune signature was consolidated in a validation cohort. Conclusion We developed and validated a stromal-immune signature to predict prognosis in surgically treated ICC. These findings provide new insights into the stromal-immune response to ICC.

Background: Intrahepatic cholangiocarcinoma (ICC) is a highly desmoplastic tumor with poor prognosis even after curative resection. We investigated the associations between the composition of the ICC stroma and immune cell infiltration and aimed to develop a stromal-immune signature to predict prognosis in surgically treated ICC. Patients and methods: We recruited 359 ICC patients and performed immunohistochemistry to detect α-smooth muscle actin (α-SMA), CD3, CD4, CD8, Foxp3, CD68, and CD66b. Aniline was used to stain collagen deposition. Survival analyses were performed to detect prognostic values of these markers. Recursive partitioning for a discrete-time survival tree was applied to define a stromal-immune signature with distinct prognostic value. We delineated an integrated stromal-immune signature based on immune cell subpopulations and stromal composition to distinguish subgroups with different recurrence-free survival (RFS) and overall survival (OS) time. Results: We defined four major patterns of ICC stroma composition according to the distributions of α-SMA and collagen: dormant (α-SMAlow/collagenhigh), fibrogenic (α-SMAhigh/collagenhigh), inert (α-SMAlow/collagenlow), and fibrolytic (α-SMAhigh/collagenlow). The stroma types were characterized by distinct patterns of infiltration by immune cells. We divided patients into six classes. Class I, characterized by high CD8 expression and dormant stroma, displayed the longest RFS and OS, whereas Class VI, characterized by low CD8 expression and high CD66b expression, displayed the shortest RFS and OS. The integrated stromal-immune signature was consolidated in a validation cohort. Conclusion We developed and validated a stromal-immune signature to predict prognosis in surgically treated ICC. These findings provide new insights into the stromal-immune response to ICC.